Have you ever noticed that your child walks on toes? Have you seen with normal gait patterns suddenly the child starts walking on foot? Do you know why your child walks on the toe? What could be the reason? Even after your several attempts, your child walks on the toe.
Let’s find out why children walk on their toes?
Toe walking is a common developmental pattern, a child adapts to their early age which is characterized by a child walking on their toes, with little or no heel contact with the floor throughout the majority of their day. Although the balance of the child is normal he may walk and follows a common walking pattern but he will walk on toes.
Some amount of toe walking is normal and expected for children as they explore movement as young walkers. Toe walking is considered normal within 6 months of the start of independent walking. A child should be walking with their feet flat on the floor by 2 years of age and should be walking with a heel-to-toe pattern by 3 years of age. 1
However, if the toe walking persists past this age, seeking medical attention is recommended (American Academy of Orthopaedic Surgeons, 2017; Mayo Clinic, 2018).
Consequences of toe walking
If your child is still toe-walking after age 2, there may be an underlying condition such as a short Achilles tendon that prevents the heel from touching the ground; a movement or muscular disorder such as cerebral palsy and muscular dystrophy; autism spectrum disorder, idiopathic toe walking or simply habit. For some toe-walkers, the vestibular system may not be giving the brain accurate information on body position and movement. Or, sensory processing disorder can make a child oversensitive to touch. These kids rise up on their toes to avoid uncomfortable surfaces or discomfort from the sensation of weight against their heels. They may also avoid socks, shoes, and even bare feet. Consequently, toe walking can lead to pain in ankles, knees or hips; difficulty with squatting or climbing stairs; and decreased hip or core strength due to postural alignment issues.
A recent article in the Journal of Child Neurology investigated the differences between the motor skills and sensory processing abilities of children who do and do not have an idiopathic toe walking gait. Sixty children (30 with idiopathic toe walking and 30 without), ages 4 through 8, were tested with a number of norm-referenced assessments.
The results indicated that when compared to children who did not toe walk, children with an idiopathic toe walking gait had:
It has been observed in the finding of the article that children walk on toes might have cognitive-perceptual, sensory processing issues.
Is toe walking a concern?
Although toe walking seems harmless, it can impact your child’s safety during walking and gross motor play. Toe walking puts the child at an increased risk of tripping and falling because they are not picking up the front of their foot, causing decreased clearance between their foot and the ground. Many parents of children who toe walk report that their child may trip and fall if he or she is not watching where they are walking.
Children who toe walk may have an increased or decreased sensitivity to sensory information. This means that they process information differently through the vestibular, tactile, and proprioception systems, which may make it difficult to coordinate body movements. The body’s vestibular controls our sense of movement and balance. Children with sensory issues related to the vestibular system have a different awareness of their body position and feel stabilized while toe walking.
Prolonged toe walking puts an abnormal amount of stress on the bones and ligaments in the ankles, knees, and hips. Over time this can cause the bones to grow incorrectly and/or overstretch ligaments which further puts the child at risk for injuries and joint pains as they grow.
Toe walking also decreases the child’s base of support, which makes it harder for them to balance. If you try to stand on your toes instead of flat feet, you will notice that your body sways more and you may feel unsteady. This unsteadiness makes it harder to balance during walking, jumping, and hopping. As the child continues to toe walk, their heel cords become tight and their ankle dorsiflexors (muscles that lift the foot upward) become weak. This can make stair navigation, squatting and jumping more difficult because of this decreased flexibility and strength
causes a child to walk on their toes
Toe walking and Autism
A dysfunctional vestibular system, a common problem in autism, may be responsible for toe walking. The vestibular system provides the brain with feedback regarding body motion and position. It may be possible to reduce or eliminate toe walking by providing the person with therapeutic vestibular stimulation (e.g., being swung on a glider swing).
Well, Toe walking is not always related to autism or the child dealing with ASD has a possibility of toe walking, but this has been seen in many patients that child might involve the feature of Toe walking
signs/symptoms of toe walking?
Many children who walk up on their toes may demonstrate any or all of the following (American Academy of Orthopaedic Surgeons, 2017; John Hopkins Medicine, 2019):
What to do?
Your child’s pediatrician is likely to refer your child to physical therapy and Occupational therapy if a sensory issue, to assist with addressing your child’s toe walking in a conservative manner. you need to see your child developmental pattern make videos of your child’s toe while walking or standing A physical therapist can assist with developing a strengthening and stretching program for your child’s tight calf muscles to facilitate the obtainment of the necessary ankle dorsiflexion (toes up) range of motion needed to utilize a heel-to-toe walking pattern. They will provide necessary gait training and assist with developing strategies to be utilized at home to correct your child’s walking pattern, an occupational therapist helps you to overcome the sensory symptoms associated with toe walking with orthopedic correction which involves casting , splints depending upon the need of child
It is essential for parents to learn as much as possible about the toe walking as I always mention in my blogs two children are not the same, the symptom might fade out with the development you need to discuss with the medical practitioners but keenly observe and if you find a sign don’t think twice to bring your child to the doctor.
you’re concerned, be sure to speak up at your next appointment with your pediatrician. Be an advocate for your child – you know him better than anyone! Get things taken care of before something small turns into something that will take more serious measures to correct
Recall in your mind the last time you saw the Ferris wheel IN ANY AMUSEMENT PARK with sparkling lights bright flash was impressive left some good impact for a while and went on. But people struggling with ADHD may be struck on the wheel, maybe on a lightning effect or maybe something we can’t even think of! Now, picture this brain inside a young child for whom coping skills is an ongoing learning experience, During bright flashes, rotating wheel activity there is an explosion of creativity, spatial discrimination, gravity influences interaction, attention and utilization of information.
However, between the episode of turning clockwise rotation of a wheel or anticlockwise music of wheel lighting effect creates silence, darkness, space, voids of productivity in the middle of ADHD.
Unknowingly different thoughts, many unsolved queries, stocking on the particular incident and trying to correlate that situation into the present scenario.
“Many questions are unanswered in the minds of ADHD “
According to DSM-IV: ADHD is a disruptive behavioral disorder characterized by a set of chronic and impairing behavior patterns that display abnormal levels of inattention, hyperactivity, or their combination.
It is primarily by inattention, easy distractibility, disorganization, temporize, forgetfulness and lethargy or fatigue. Symptoms usually show before the age of seven. It is most common in school-age children.
It is normally used to describe children who have three main kinds of problems:
Children falling into this category are commonly encountered with all the above problems mentioned .they find difficulty adjusting and adapting to the environment, people, and society.
The symptoms are also pervasive, meaning they occur in multiple settings, rather than just one.
They are the same as another child of your house but there may be difficulties of a certain domain for example: sensory, cognitive, behavior or any other depending upon the need of the child.
It’s like “ Multiple Films on a Single Screen”, it means when multiple films are going on a single screen we can't understand similarly a child with ADHD have many incidents going on due to which they cant adjust and understand how to react.
ADHD IS NOT ONLY ABOUT :
X All about hyperactivity. Kids with the inattention type of ADHD may appear “daydreamy” or off in their own world.
X A problem with laziness.
X ADHD is caused by differences in brain anatomy and wiring.
X Something most kids totally outgrow.
X Many kids diagnosed with ADHD have symptoms that persist in adulthood.
It’s about what is less or what is more, some children have different symptoms of the same disorder, as a parent caretaker, the teacher you need to be more understanding about the pain the symptoms your child is growing through.
“The child might be alike of each other but grown differently
Red flags of ADHD
Inattention
Hyperactivity
Impulsivity
Combined presentation
• The individual meets the criteria for both inattention and hyperactive-impulsive ADHD presentations.
How to diagnose?
We know that young children have lots of energy and like to be active. Young children also tend to have a short attention span - they soon get tired of an activity and want to move on to something new. So how can you tell whether a child has ADHD or is simply restless or bored? To a certain extent, it may be a matter of degree - children with ADHD are not just very active but have a wide range of problem behaviors which can make them very difficult to care for and control.
It is important to remember that no label or diagnosis will give a perfect description of an individual child. Children are all different and will express their problems in different ways.
When symptoms such as inattention, hyperactivity, or impulsiveness are significantly affecting a child’s ability to learn and to complete activities of daily living, then a diagnosis and intervention should be sought.
Occupational Therapists, Medical practitioners are happy to conduct an assessment and begin intervention as required. Be sure to speak with your child’s teachers and carers to gather information about any concerns they may have as this will help prioritize therapy intervention goals.
As we have DIY FACE PACKS ..WHY CAN’T WE HAVE DIY MULTISENSORY ROOMS. Yes you heard it right we can create child DIY MULTISENSORY ROOMS
The room incorporates all of the senses and multisensory rooms incorporate all the senses into one whole. It can help reduce anxiety and agitation with calming music, scents, and more. The lights and tactile engagement can also engage children and hold their attention by stimulating their senses.
The child will understand different stimuli and try to incorporate the desired response expected.
Think about what you already have at home that can be added to space.it includes what you easily have at your doorstep to do wonders for your child. Most rooms limit light, do you have curtains that could be used to cover the window? The same curtains could be used to create a hidden nook in a corner. Christmas lights, especially flashing options, can be used as visual stimuli. Once you know what you have, you can start deciding what you should buy.
Bouncing ball
It can be of any size depending, but personally I would prefer to use 3 different sizes: one may be the size of your child other two can be of larger than your child size and other can be layered according to your wish size it could be peanut ball, pogo ball, or normal size ball.
Students always start by bouncing on a ball in time to a metronome. It’s very important to provide consistency, and starting (and ending) each session on a bouncing ball allows for ease of transition and provides predictability. Next, students either do a set rotation among the stations or make their own choices.
You can tell a child to roll the ball with a specific target.
peanut ball
pogo ball
gym ball
Swing
A swing can make a great centerpiece in a sensory room for a child on the autism spectrum. For many children, the swing can be a great reinforcement. Make sure to use it before asking your occupational therapist about the swing time or etc!
As some children may require There are different types of swings and while they all provide vestibular stimulation — a sense of movement or gravity — they serve different purposes. A lycra swing provides deep pressure or a “cocoon” feel. A platform swing lays low to the ground and provides bigger movement sensations. If mounted to a swivel hook, a child can lay on their stomach and spin in a swing using their arms. A net swing provides linear movement, much like a typical swing. Depending upon your child need by consulting your therapist you can hang swings and do many activities
The swing should be kept in a detachable way so that parents can do any activity too at the place of swing.
Lightning ( light bulbs )
You don’t need high-tech lighting equipment to do the trick. You can add a relaxing glow to your sensory space by using some holiday lights, net lights, string lights, battery-powered candles, glow candles, bulb fancy lights, led bulbs Lighting is such a powerful thing
It influences us in subtle ways and can change the way we feel. For example, fluorescent overhead lights that emit a cool tone can make us feel uncomfortable. Warm, soft lighting can make us feel relaxed. Don’t be afraid to use lighting to create a relaxing atmosphere and comfy ambiance.
Either you can hang the lights or put the lambs under the proper guidance of a therapist
Trampoline
You can use a trampoline for jumping or overcome the hyperactivity level of a child. The trampoline should be placed at the corner of the room to do multiple activities.
Music
You don’t need a state-of-the-art sound system. A simple stereo or inexpensive mini sound dock to play music over is a wonderful option. Or, simply play some songs on your phone to have as background noise in your sensory space. Music can change the way we feel.you can use Bluetooth speaker or Alexa to play a piece of pleasant music in the dark centered room with led light effects
Bean bags
You can use a bean bag or deep pressure or toss a bean bag activity. The bean bags can be placed anywhere in a room.you can make your child walk on a bean bag with hand-assisted for balance and coordination. Bean bags can be ordered from offline or online.
Ball pool
You can either buy a big swimming pool made up of plastic or a big cartoon. Plastic balls can be placed inside a pool .this can help for calming effects
Fine motor skills
You can use fine motor activities mentioned in my other blogs you can check!
Textured walls or Textured mats
You can either make your own textured wall including different textures hang on the wall or order online. It may involve pebbles, ribbons, coarse mat texture.
You can buy or use different texture mat aether place it on a big yoga mat, Make your child walk on the different mats!
Curtains and blinds
It has been suggested that it’s best to avoid using slatted blinds, particularly vertical ones, as these can be distracting. Curtains may be a better option, with blackout curtains helping someone who is particularly sensitive to light. If someone has a tendency to pull on curtain rails, curtains can be held up with Velcro.
The plastic stick-on covering/ blinds can also be placed on windows, giving privacy while letting some light in.
fiber optics/bubble tubes
They can be placed on the dark side of the room curtains or doors can be placed . This may improve eye contact, with correct behavior intervention fiber optics,or help to reduce the hyperactivity.
Sensory basket
containing a selection of sensory items that can travel around with an autistic person.
This could include stress balls, a whistle with the pea removed for hard blowing, unbreakable mirror - for the person to be able to see their emotions, scented lotions
Colour and patterns of the room
It is generally accepted that low arousal colors such as cream (not yellow or white) should be used for walls and patterned wallpaper should be avoided. Soft furnishings should also be kept fairly plain. Single-colour, painted walls can also eliminate the possibility of wallpaper being removed. Patterned floors can be confusing to walk across and may increase anxiety or cause people to become fixated.
Dupatta flow
You can use pieces of clothes or a bed sheet to tie it with a rod to tell the child to stretch.
The sensory room can be customized according to the need or demands of a child. One thing to be kept in mind that the child may or may not like some of the activity better to consult your therapist about what to be added into the room because sensory rooms will act as an adjunct to the therapy. The room can be altered with many new activities in the sensory room depending upon the need of your child.
The sensory rooms can be seen in the number of variety :
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